2006-04-19_REPORT - M1994092

• Permit No: M1994092
• IBM Index Class Name: Report
• Doc Date: 4/19/2006
• Doc Name: Annual Fee/Report/Map
• From: Fremont County
• To: DMG
• Violation No.: MV2006012
• Media Type: D
• Archive: No

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Fpr 19 06 03:OSp FREMOMT COUNTY
7192767321
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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Fremont County
M-1994-092
Iron Mountain Road Gravel Pit
January 23,2006
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Division ui ~...,;.
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$281.00 (Due on or before your anniversary date)
Fremont
p.2
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an
operator shall submit the annual lee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming yeaz, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased far the year, if any.
Please attach ym~r revised written anneal report and anneal re~nrt ma= to this form- please (tote that an
adequately labeled map that clearly delineates and includes the above elements may since for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Paul Garrett
Permittee Name: Fremont Cowity
Address: Fremont Cowtty Commissionets
615 Macon Ave., Room #105
Canon City, ('O 8]212
Phone Number: [phone]
Eax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below, or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
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Signature of Corporate O tcer, Owner, or Designee
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Date